本研究的目的是评估阿特伊珠单抗与最佳支持性护理（BSC）相比作为辅助治疗，对于切除和铂类化疗后期II-IIIA非小细胞肺癌（NSCLC）患者的成本效益，其肿瘤细胞的程序性死亡配体1（PD-L1）表达≥50%，并排除ALk/EGFR突变的患者，从法国的集体观点出发。考虑了一个20年时间跨度的五态马尔可夫模型，包括来自IMpower010试验的无病生存期（DFS1），三种进展状态（局灶性复发、一线和二线转移性复发）以及死亡。在模型中考虑了效用、质调整生命年（QALY）降低与不良事件相关的费用、资源使用和转化概率。这些输入来自IMpower010试验、文献和临床专家的意见。模型不确定性通过确定性、概率敏感性分析和情景分析进行评估。阿特伊珠单抗与BSC相比， QALY增益为1.662，主要是由于在DFS状态中额外的生存时间，寿命增加为2.112年。阿特伊珠单抗与BSC的增量成本效益比（ICER）为21,348欧元/QALY。敏感性分析显示，模型内的不确定性对结果影响有限。将DFS生存曲线更改为其他合理的分布会产生低于20,000欧元/QALY的ICER。在第二到第五年引入被治愈患者的比例增加（91.5%）将ICER降低至13,083欧元/QALY，而在阿特伊珠单抗治疗组中引入第二年的疗效下降会使ICER增加至33,755欧元/QALY。阿特伊珠单抗作为PD-L1≥50%和无ALK/EGFR突变的切除期II-IIIA NSCLC患者的辅助治疗，其ICER低于法国其他肿瘤药物，与其他肿瘤的辅助治疗的ICER相似。版权所有©2023 Elsevier B.V.发表。

The objective of this study was to assess the cost-effectiveness of atezolizumab versus best supportive care (BSC) as adjuvant treatment following resection and platinum-based chemotherapy for patients with stage II-IIIA non-small cell lung cancer (NSCLC) whose tumours have a programmed death-ligand 1 (PD-L1) expression ≥ 50% of tumour cells and excluding those with ALK/EGFR mutations, from a French collective perspective.A five state Markov model over a 20-year time horizon was considered, including disease-free survival (DFS1) from IMpower010 trial, three progression states (locoregional recurrence, first and second-line metastatic recurrence) and death. Utilities, quality-adjusted life year (QALY) decrements associated to adverse events, costs, resource use, and transition probabilities were considered in the model. These inputs were sourced from IMpower010 trial, literature, and clinical experts' opinion. Model uncertainty was assessed through deterministic, probabilistic sensitivity analyses and scenario analyses.Atezolizumab was associated with a QALY gain of 1.662, mainly driven by additional time spent in the DFS state, and a life-year gain of 2.112 years. The incremental cost-effectiveness ratio (ICER) for atezolizumab versus BSC was €21,348/QALY gained. The sensitivity analyses highlighted that uncertainty within the model had limited impact on results. Changing the DFS survival curves to other plausible distributions produced ICERs below €20,000/QALY. Introducing an increasing proportion of cured patients (91.5%) from year two to year five reduced the ICER to €13,083/QALY, while including a loss of efficacy at year two in the atezolizumab treatment arm increased the ICER to €33,755/QALY.Atezolizumab as adjuvant treatment in stage II-IIIA NSCLC resected patients with PDL1 ≥ 50% and without ALK/EGFR mutations has a lower ICER than other oncology drugs in France and a similar ICER to other adjuvant treatment in oncology.Copyright © 2023. Published by Elsevier B.V.